The overall goal of the proposed project is to measure and characterize quality of life (as utilities) in emphysema, and the impact of comprehensive pulmonary rehabilitation and lung volume reduction surgery. The secondary goals are to validate a new instrument for estimating utilities in patients with emphysema and to determine possible predictors for patients' utilities. to accomplish this task, we will validate an instrument for estimating utilities in patients with emphysema. The instrument will then be applied in a longitudinal prospective manner to a cohort of patients undergoing first comprehensive pulmonary rehabilitation and the lung volume reduction surgery. Data from this research will be useful for the assessment of new treatments of emphysema with methods such as cost-effectiveness analysis.